1) The study aimed to quantify noise levels in a pediatric intensive care unit (PICU) and implement low-cost measures to reduce noise. 2) Baseline noise levels averaged 50-55 dBA, above recommended limits. A behavior modification program was able to lower levels slightly but not significantly. 3) Excess noise can harm patients and staff by disrupting sleep, increasing stress levels, and interfering with work. Major noise sources included alarms, conversations, and equipment operation.

1. Reduction of Noise Levels In The Pediatric Intensive Care Unit (PICU) Of
Beaumont Hospital
Avinash Konkani1, Dr. Barbara Oakley1, Dr. Barbara Penprase1, Julie Topacio2, S. Noel Simpson2 and Beth Kring2
1
Oakland University, Rochester and 2Beaumont Hospital, Royal Oak
Objectives:
•To quantify noise levels and
Results:
their variability within the Effects of noise on patients: Different methods to reduce the
Beaumont Hospital’s PICU. noise levels:
Hospital noise increases risk of hyper
•To implement appropriate low-
tension and ischemic heart disease in the  Behavior modification program – cost
or no-cost sound reduction
patients. effective method
measures, including behavioral Sleep disturbances  Renovation of the ICU with sound
modification, to reduce the noise. Elevated blood pressure absorbing materials
Increased heart and respiration rates  Sound masking – good for speech privacy
•To quantify the reduced noise
Delayed wound healing but does not help in reduction of noise level.
levels within the ICU after  Use of ear plugs – for patients
Diminished immune responses
implementing the sound  Applying “Quiet Time” protocol
Pituitary and adrenal gland stimulation
reduction measures, thus  Alarm design of Medical devices to reduce
obtaining a before and after
false alarms
measure of the effectiveness of  Efficient management of alarms
the program.
Effects of noise on nursing staff :
Example of sound sources with their sound
pressure levels in dBA. Adapted from
Behaviors that are straightforward to
(http://www.sengpielaudio.com/TableOfSoundPressureLevels.htm “Noise is potentially a significant contributor implement:
)
Sound
to higher heart rates and tachycardia among
Sound source examples with
distance
pressure level nurses, as well as nurses’ stress and
 Keep the mobile phones, pagers on vibrating mode
Conclusion:
in dBA annoyance.” (Morrison et al., 2003) References:
2-stroke chain-saw at 10 m  Noise can negatively affect the nurses in their  Any loud conversation and laughing should be avoided On an average the
 Berglund, B, T Lindvall, et al., “Guidelines for
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routine work environment: as much as possible in the PICU LAeq noise levels Community Noise.” World Health Organization http://
distance
 Irritation and fatigue  Limit bedside conversations with colleagues remained above 50 to www.who.int/docstore/peh/noise/guidelines2.html
Passing car at 7.5 m distance 75
 Lack of concentration  Keep the telephone ringer volume as low as possible (accessed Mar/16/ 2011).
Noisy lawn mower at 10 m
60  Limit the number of telephone calls in the PICU 55 dBA and a  Choiniere, DB. “The Effects of hospital noise.”
distance  Tension headaches
Low volume of radio or TV at 1  Elevated noise level can affect speech  If possible create quiet time periods for at least an hour behavior modification Nursing Administration Quarterly 2010; 34, no. 4:
327–333.
m distance, noisy vacuum cleaner
at 10 m distance
55
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 Garbage deposition in the bins should be done gently
Noise of normal living; talking, or
45
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radio in the background
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Learning or concentration is
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40
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Very quiet room fan at low speed
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at 1 m distance At 45 dBA- yellow light indicator
Sound of breathing at 1 m Hospital ICU: will be “ON”
 Kahn, D.M., T.E. Cook, et al. “Identification and
distance
25
Operational Sounds – by staff and medical modification of environmental noise in an ICU
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Structural Sounds- by –building (ventilation, The Authors are thankful to the OU-Beaumont
The recommended sound level limits for hospital “ON” impact of a noise awareness educational program.”
patient rooms as defined by different organizations air conditioning system, doors) multidisciplinary research award committee for Advances in Neonatal Care 2010; 10, no. 6: 343-351.
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WHO Intnl Noise EPA
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Day 35dBA 45dBA 45dBA
equipment packages , storage drawers, closing and perceived work environment in a neurological
Evening - 40dBA -
doors etc. intensive care unit.” The Journal of the Acoustical
Night 30dBA 20dBA 35dBA
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